Author's note: Sorry about the delay. I was almost done with the chapter,
when I decided to revise it in order to integrate a reference to last
Thursday's episode. This chapter takes place the day after "Touch and Go,"
which, in my story, occurred around the end of January. Also, if you don't
remember the 'brat pack', see chapter 2.
*****
Michael Gallant stood in Trauma 1, after his latest patient was wheeled out, and flicked off his latex gloves. There was something satisfying about the snapping sound they made: a case closed, a life saved - or, in this instance, an MI stabilized and transferred to cardiology. The young resident supposed that the gloves made the same sound when one lost a patient, but on such occasions he had never noticed irrelevant noises.
Gallant observed as Dr. Romano, standing nearer to the door, facing away, also removed his gloves. Romano slipped the thumb of his prosthesis into the wrist of his right glove, then, with a pause and soft mechanical whirr, closed the hand. With the cuff of the glove thus secured, he pulled his right hand out. Then he opened the artificial hand, retrieved the glove, and used his right hand to remove the glove that was on the prosthesis. He dropped the gloves into the trash, and left the room without a word or backward glance.
Gallant was not surprised. Romano had been like this for three or four weeks now. He did what he needed to do, but lifelessly - in sharp contrast with his usual bombastic personality and his over-the-top anger of recent months. Unbidden, the image of a star exploding into a fiery giant, then imploding into something cold and dark, popped into Gallant's mind, and he frowned.
Lately, Michael had been seeing a lot of the ER Chief. Practically every time Romano worked on an unstable patient, he brought Gallant along with him. When Gallant finally pressed for an explanation, Romano had reluctantly admitted that he ran into difficulty in a trauma and wanted to have a resident along for assistance, adding bitterly, "If you want more details, pester Dr. Lewis."
Gallant was a bit disturbed that he hadn't been informed earlier about what was going on. Grudgingly, he acknowledged that he was also flattered. This latest development was consistent with Romano's past, frustratingly inconsistent, behavior: he called Gallant an affirmative action imbecile, then when he needed someone to treat his burned arm he asked for him; he insinuated that Gallant had only half a brain, then he depended on him as his back-up. Michael mused with a wry grin, 'If I just ignore everything he says, I might get the impression that he thinks I'm a good doctor.'
Exiting the trauma room, Gallant checked the board, then headed into the lounge for a break. Minutes later, he was facing off across a chessboard with Greg Pratt. As far as Gallant knew, the game had always been kicking around the lounge, mostly ignored. Then Lester brought in a chess clock, and suddenly the lounge was hopping several times a day with the rhythmic whap-whap-whap of players making their moves and slapping down on the timer buttons.
This time, however, Pratt's mind was not on the game, but on a run-in with their supervisor he'd had yesterday. Gallant remembered the patient involved, a young man with ankylosing spondylitis who'd been in a car accident with his father. Pratt vented:
"Anesthesiology's taking their sweet time getting down here, and the guy's losing his airway, so I go to intubate. Right in the middle of the procedure, Romano barges in and makes me stop. I tell him the kid needs an airway NOW, so he tells Lester to prep for an emergency tracheotomy."
Gallant raised his eyebrows, "That's kind of extreme."
"That's what I thought. So I told him I was on it, I almost had the tube in, there's no need to be cutting the guy up. And he's like, 'I'd rather trach him than break his neck.'"
"So, what happened?"
"He and Lester did the trach, Anesthesiology's pissed, and so am I. I mean, would it kill Romano to admit that I might just know what the hell I'm doing?"
Given the possibility of total paralysis, Gallant was inclined to side with Romano on this one. A tracheotomy, while unpleasant, would heal. But he knew that Pratt was still smarting over being kicked to the curb by Valerie, so he decided not to press the issue. Instead he asked, "How is the patient now?"
"Oh, he'll be fine - except for the unnecessary hole in his throat."
Just then, the residents were interrupted by Sam, who burst into the room saying, "Stop the clock, boys, we've got wounded!"
Gallant got up immediately, froze the chess timer, and asked, "What is it? MVA? GSW?"
"Nah, just the 'brat pack', but they're getting hyper out in chairs," Sam replied, stifling an uncharacteristic giggle. "There was a M*A*S*H marathon on TV yesterday," she explained, "and Alex HAD to watch all twelve hours. I've still got it on the brain."
"So, does that mean we can call you 'Hotlips'?" Pratt flirted.
"Only if you don't mind having your tongue sutured to your chest," the nurse answered sweetly.
Pratt and Gallant went out to the waiting area. "Where's Dr. Romano?" Gallant inquired, recognizing the children. "He's treated some of these guys before."
"Busy fixing Red's mess," Sam sniped, nodding toward the Exam 1 window. Morris, Romano, and a patient were partially visible through the blinds. Romano was pacing, shaking his head in obvious disapproval.
Pratt pulled Gallant aside and said, "Let's take the hand lac before Romano gets here," gesturing toward a little girl with a bloodied towel wrapped around her hand, held in place by her teacher. At Gallant's questioning look, he explained, "These kids have enough stacked against them without having to deal with Mr. K.K.K."
The patient in question was black, her light brown face smudged with dirt and her hair pulled back into three messy braids. Against his better judgment, Gallant found himself defending Romano, "He wouldn't say anything to a child."
With a thoughtful expression, Pratt replied, "Maybe not, but kids pick up on that stuff." Then, watching the teacher struggle to keep the towel in place on the squirming girl, he added more lightly, "Besides, she's probably gonna need stitches and he can't sew worth a damn on a moving target."
The two residents proceeded into an exam room, with the teacher and child in tow, leaving the remaining students with the teacher's assistant. Pratt addressed the little girl, smiling, "Hey, Princess, what happened to your hand?"
The girl didn't respond, but Sam, swooping by to drop off some supplies, put in, "4 cm lac to left palm, self-inflicted with a glass bottle, tetanus is current."
The teacher, Ms. Anders, was visibly upset. "She must have found the bottle on the playground. I got her here right away. It looks deep," she fretted.
"We'll take good care of her, Ma'am," Gallant soothed.
"That's right," Pratt said, then looking at the chart for the name, he asked, "OK, Kiesha, can I see your hand please?"
Kiesha didn't answer, but when Pratt reached for her, she pulled her hand back and held it against her body protectively.
"Kiesha?" He asked again. Getting no response, he turned to her teacher, "Can she talk?"
"Yes," Ms. Anders explained, "but she doesn't very often, and not usually to people she's just met. She understands most of what you say to her, as long as she's tuned in." Addressing the girl, she told her, "Kiesh, you need to let the doctors take care of your hand. It's OK. Nobody's going to hurt you."
With prompting from her teacher, Kiesha slowly uncurled her arm and cooperated as Pratt and Gallant irrigated and disinfected the wound. The residents were about to begin suturing, when a crash and screaming came from outside. Ms. Anders groaned, recognizing the cries. "That's one of mine," she sighed, looking toward the door.
"You wanna go check on them?" Pratt offered. "We're fine here," he said, smiling toward the girl, "She's being an angel. We'll bring her out in a few minutes."
As the yelling outside intensified, the teacher nodded gratefully. Patting Kiesha on the shoulder, she got up to go, saying, "I'll be right outside."
Kiesha showed no reaction as her teacher exited the room. But she reacted strongly when Gallant approached with a needle; she pulled her hand away and tensed as if she might bolt. Pratt, sitting on her right side reached around behind her with his left arm, holding her in the chair. With his right arm across her, he secured her injured left hand, saying, "Don't worry, honey, this won't hurt a bit."
Pratt's attempts to restrain and calm the child had the opposite effect. She went ballistic, kicking and thrashing. She managed to knock the needle from Gallant's hands and arched upwards to escape Pratt's grasp. When Pratt moved his arm up to compensate, she bit down hard on his forearm. Suppressing a curse, he pulled his arm away and ducked his head - inadvertently bringing his face within reach of Kiesha's foot. The toe of her shoe connected solidly with his nose.
Pratt yelped and backed away. Surprisingly, Keisha did not get up and run, but, instead, curled into herself on the chair. Pratt felt his nose and discerned that it wasn't broken. "Oh man, I'm bleeding," he moaned, "let me get it stopped and I'll be back in a minute."
Pratt left the room, applying pressure to his oozing proboscis. Gallant gathered the supplies that had been strewn in the scuffle, and watched his patient go from thrashing wildcat to silent lump in the blink of an eye. The door opened. Gallant looked over, surprised that his fellow resident could return so quickly.
Instead of Greg, Dr. Romano entered the room, laughing softly. He addressed the little girl in a delighted tone, "You hurt Pratt!"
'It's nice to hear him laugh,' Gallant thought, shaking his head, bemused, 'Of course it would be nicer if he wasn't laughing at somebody else's misfortune.'
Kiesha was apparently unused to having her violent outbursts met with such glee. She looked up at Dr. Romano, her placid mask turning into a slightly puzzled expression.
"You know, we're going to have to stitch up your hand, sweetheart, even if you're not crazy about the idea," Romano told her matter-of-factly. Then, addressing Gallant, he asked, "How far did you get?"
"Cleaned and irrigated, but it might've been contaminated when she moved."
Romano nodded, "We'll numb, then re-disinfect and suture." Turning to Kiesha, he said, "I'm going to hold your hand steady so Dr. Gallant can give you a shot and sew up your cut. He'll put something on your hand so the needle won't hurt much. It might sting for a second, then your hand will feel tingly."
He placed his hand, palm up, on the table, and gestured with his head to indicate that she should do the same. At first, she did nothing. But after several seconds she slowly complied, placing her up-turned left hand on top of his right. He lightly curled his pinky finger around her wrist and held her fingers straight with his thumb.
Gallant noticed that, while their patient's hand was restrained fairly securely, the rest of her was not. Romano was sitting on Kiesha's right side, in the chair Pratt had vacated, with a good foot and a half between his body and hers. His prosthetic arm was hanging down at his side. If the girl managed to pull away from his grip on her hand, there was no way he would be able to grab her. 'Oh, well,' Gallant reasoned, 'grabbing her didn't work so well last time anyway.'
Kiesha was tense, but still, as Gallant administered the injection. She relaxed almost imperceptibly when it was over. Romano whispered, "Good girl." Kiesha looked over at him. He met her gaze with a twinkle in his eye, then looked down at his lap and then back at her. Much to Gallant's surprise, the child accepted this nonverbal invitation and scooted over onto Romano's lap.
As Gallant began suturing, Romano quietly asked, "Kiesha, did you do this on purpose?" glancing toward her hand. She didn't exactly nod in reply, but there was something affirmative about the way she cocked her head. Romano continued, "Well, don't do that again." His tone was serious, but with an edge of wry self-consciousness at the absurdity of trying to reason with a kid who intentionally mangles herself.
The girl stared up at Romano intently; then she reached up with her free hand and touched his face. Reflexively, he drew back a little, but the way they were positioned there really wasn't anywhere for him to go. Lightly, she tapped her fingertips along his beard, from one end to the other. She tilted her head back and giggled, a low musical sound, while patting the side of his face.
Gallant, watching out of the corner of his eye, had to force himself not to laugh. Romano had a rare unguarded, almost silly, smile on his face. He looked confused, but was clearly charmed by the girl's bizarre display of affection. Then, as suddenly as Kiesha started, she stopped. Sticking her thumb in her mouth, she curled up against Romano's chest and rested quietly through the remainder of the procedure.
*****
After returning Kiesha to her teacher and discussing follow-up care, Robert entered the lounge. Pratt was sitting on the couch with an ice pack pressed against his nose. The bleeding had stopped, but there was still a little swelling. A nicer man would have offered sympathy, or at least not gloated. Robert was not such a man. He laughed at Pratt, saying, "Wait 'till you see what I told Miguel to do to you."
Pratt was galled by Romano's attitude, but also amused at the older man's complete lack of subtlety - 'the little prick can't even pretend he's not enjoying this'. He growled back, "Keep your minions away from me."
Romano chuckled. He couldn't remember the last time he was in such a good mood. It was fun to watch the arrogant lout suffer. And succeeding where another guy failed, even if it was at something as insignificant as wrangling a nutty little kid, was icing on the cake.
Since Anspaugh's reprieve, Pratt continued to be a thorn in Romano's side. It wasn't Pratt's arrogance, exactly, that pissed him off. It wasn't even the fact that the resident didn't have the goods to back up his high opinion of himself. Frankly, few people did - the world of medicine was full of enormous egos held up by flimsy platforms of talent. No, what really bugged Romano about Pratt was that Pratt thought HE was incompetent. Each time he gave Pratt an order there was that skeptical look, questioning whether Romano knew what he was talking about.
It drove Robert nuts. "Rocket Romano" had never been incompetent at anything in his life. He knew that others regarded him as a mean son-of-a- bitch, but there was always the understanding that he was truly excellent at his craft. Until recently, that is. Now, while he was better than Pratt gave him credit for, he would never again be the best of the best. And he wasn't really sure how to live with being mediocre. 'Aw, hell - I just talked myself out of my good mood,' he thought, groaning softly.
As if on cue, another mood-killer walked through the door of the lounge. Morris shuffled in, glanced around, saw the unwelcoming eyes of his colleagues, grabbed a piece of cold pizza from the 'fridge, and split. Romano shook his head, still disgusted with the red-haired resident's inept performance earlier. He tried to focus on happier thoughts, like Pratt bleeding. Only Pratt wasn't bleeding any more, and now he was speaking:
". . . you don't see anything odd about the fact that I'M the one you're trying to fire?"
"Why are you talking to me? You know I hate that," Romano responded dismissively.
"You can't possibly think that I'm the worst resident here. But I'm the one you're gunning for. In my book, that's discrimination."
"Oh, fine. After I get rid of you, Red's next. Happy?"
"I'm serious, man," Pratt pressed, growing irritated with Romano's flip attitude.
"What do you want me to say?" Romano sighed, "You're reckless and annoying, and I want you gone. Fortunately for you, the powers-that-be don't give a rat's ass what I want. Anyway, it's considerably harder to fire somebody like Morris."
"Why?" Pratt asked, taking advantage of his supervisor's atypical candor.
"Because he's an idiot. It's not like he's doing it on purpose." At Pratt's frown, he continued, "Hey, if it were up to me we'd do IQ tests like the airlines do drug tests . . ."
Hearing the word 'drug', Pratt scrutinized Romano's expression as the older man continued talking: ". . . med school and first year residency are supposed to weed out this kind of thing . . ."
'Nope. He's clueless,' Pratt concluded. This presented Greg with an ethical dilemma. He had nothing but contempt for Morris, but he had been trying to make a point to Romano, not get the other resident in trouble. Unfortunately, if he was right, Morris might pose a significant risk to patient care. He deliberated with himself, 'It's not my job to rat out other residents, especially not to a creep like Romano. But I can't just do nothing. He's the boss; he needs to know what's going on. And if he's not with-it enough right now to figure it out, somebody's gotta tell him. Damn.'
"Earth to Pratt," Romano interrupted the other man's thoughts, "You're the one who wanted to have this conversation, not me."
Instead of responding to Romano's jibe, Pratt addressed him in a pained voice, "If I tell you something, do you promise not to overreact?"
"No. Tell me anyway."
Pratt hesitated, weighing his options.
Romano prompted impatiently, "What?" Noticing Pratt's troubled expression, he repeated less harshly, "What?"
"I think Morris is using pot," Pratt blurted, before he could change his mind.
Romano snorted, "So what?"
'OK,' Pratt thought, 'I hadn't counted on him UNDERreacting . . .' Then he amended, "I don't mean on weekends, on shift."
Romano sobered and asked quietly, "What's your evidence?"
"Not a lot. And I don't want to come down on him in case I'm wrong. But he comes in smelling like it - says it's his roommate smoking. Sometimes the smell is stronger after he goes outside for a break. And one of his patients claimed that his doc lifted his 'herbal remedy' for glaucoma."
Romano looked lost in thought for a moment, then he said, "They won't let me do random drug tests, so it's one resident's word against another's. That's not enough to support a formal accusation. Especially since it could be interpreted as you trying to take the heat off yourself . . ."
Pratt opened his mouth to protest, but Romano waved it away, saying, "I know." Then he continued, "I'll keep closer tabs on him. If he thinks I'm coming down on him, that may be enough to get him to quit using around work hours. Of course, that'll leave us with his normal not-chemically-enhanced level of uselessness."
Pratt nodded, still uncomfortable with what he'd done.
Romano caught his eye and asked softly, "That really sucked for you, huh? Having to tell me?"
Pratt mumbled, "Yup." He thought he saw something like admiration in Romano's expression, momentarily.
Then it was gone, and Romano smirked, "Almost as bad as getting beat up by an eight-year-old girl . . ."
Pratt let out an exasperated sigh, as Romano left the lounge snickering softly at his expense.
*****
Michael Gallant stood in Trauma 1, after his latest patient was wheeled out, and flicked off his latex gloves. There was something satisfying about the snapping sound they made: a case closed, a life saved - or, in this instance, an MI stabilized and transferred to cardiology. The young resident supposed that the gloves made the same sound when one lost a patient, but on such occasions he had never noticed irrelevant noises.
Gallant observed as Dr. Romano, standing nearer to the door, facing away, also removed his gloves. Romano slipped the thumb of his prosthesis into the wrist of his right glove, then, with a pause and soft mechanical whirr, closed the hand. With the cuff of the glove thus secured, he pulled his right hand out. Then he opened the artificial hand, retrieved the glove, and used his right hand to remove the glove that was on the prosthesis. He dropped the gloves into the trash, and left the room without a word or backward glance.
Gallant was not surprised. Romano had been like this for three or four weeks now. He did what he needed to do, but lifelessly - in sharp contrast with his usual bombastic personality and his over-the-top anger of recent months. Unbidden, the image of a star exploding into a fiery giant, then imploding into something cold and dark, popped into Gallant's mind, and he frowned.
Lately, Michael had been seeing a lot of the ER Chief. Practically every time Romano worked on an unstable patient, he brought Gallant along with him. When Gallant finally pressed for an explanation, Romano had reluctantly admitted that he ran into difficulty in a trauma and wanted to have a resident along for assistance, adding bitterly, "If you want more details, pester Dr. Lewis."
Gallant was a bit disturbed that he hadn't been informed earlier about what was going on. Grudgingly, he acknowledged that he was also flattered. This latest development was consistent with Romano's past, frustratingly inconsistent, behavior: he called Gallant an affirmative action imbecile, then when he needed someone to treat his burned arm he asked for him; he insinuated that Gallant had only half a brain, then he depended on him as his back-up. Michael mused with a wry grin, 'If I just ignore everything he says, I might get the impression that he thinks I'm a good doctor.'
Exiting the trauma room, Gallant checked the board, then headed into the lounge for a break. Minutes later, he was facing off across a chessboard with Greg Pratt. As far as Gallant knew, the game had always been kicking around the lounge, mostly ignored. Then Lester brought in a chess clock, and suddenly the lounge was hopping several times a day with the rhythmic whap-whap-whap of players making their moves and slapping down on the timer buttons.
This time, however, Pratt's mind was not on the game, but on a run-in with their supervisor he'd had yesterday. Gallant remembered the patient involved, a young man with ankylosing spondylitis who'd been in a car accident with his father. Pratt vented:
"Anesthesiology's taking their sweet time getting down here, and the guy's losing his airway, so I go to intubate. Right in the middle of the procedure, Romano barges in and makes me stop. I tell him the kid needs an airway NOW, so he tells Lester to prep for an emergency tracheotomy."
Gallant raised his eyebrows, "That's kind of extreme."
"That's what I thought. So I told him I was on it, I almost had the tube in, there's no need to be cutting the guy up. And he's like, 'I'd rather trach him than break his neck.'"
"So, what happened?"
"He and Lester did the trach, Anesthesiology's pissed, and so am I. I mean, would it kill Romano to admit that I might just know what the hell I'm doing?"
Given the possibility of total paralysis, Gallant was inclined to side with Romano on this one. A tracheotomy, while unpleasant, would heal. But he knew that Pratt was still smarting over being kicked to the curb by Valerie, so he decided not to press the issue. Instead he asked, "How is the patient now?"
"Oh, he'll be fine - except for the unnecessary hole in his throat."
Just then, the residents were interrupted by Sam, who burst into the room saying, "Stop the clock, boys, we've got wounded!"
Gallant got up immediately, froze the chess timer, and asked, "What is it? MVA? GSW?"
"Nah, just the 'brat pack', but they're getting hyper out in chairs," Sam replied, stifling an uncharacteristic giggle. "There was a M*A*S*H marathon on TV yesterday," she explained, "and Alex HAD to watch all twelve hours. I've still got it on the brain."
"So, does that mean we can call you 'Hotlips'?" Pratt flirted.
"Only if you don't mind having your tongue sutured to your chest," the nurse answered sweetly.
Pratt and Gallant went out to the waiting area. "Where's Dr. Romano?" Gallant inquired, recognizing the children. "He's treated some of these guys before."
"Busy fixing Red's mess," Sam sniped, nodding toward the Exam 1 window. Morris, Romano, and a patient were partially visible through the blinds. Romano was pacing, shaking his head in obvious disapproval.
Pratt pulled Gallant aside and said, "Let's take the hand lac before Romano gets here," gesturing toward a little girl with a bloodied towel wrapped around her hand, held in place by her teacher. At Gallant's questioning look, he explained, "These kids have enough stacked against them without having to deal with Mr. K.K.K."
The patient in question was black, her light brown face smudged with dirt and her hair pulled back into three messy braids. Against his better judgment, Gallant found himself defending Romano, "He wouldn't say anything to a child."
With a thoughtful expression, Pratt replied, "Maybe not, but kids pick up on that stuff." Then, watching the teacher struggle to keep the towel in place on the squirming girl, he added more lightly, "Besides, she's probably gonna need stitches and he can't sew worth a damn on a moving target."
The two residents proceeded into an exam room, with the teacher and child in tow, leaving the remaining students with the teacher's assistant. Pratt addressed the little girl, smiling, "Hey, Princess, what happened to your hand?"
The girl didn't respond, but Sam, swooping by to drop off some supplies, put in, "4 cm lac to left palm, self-inflicted with a glass bottle, tetanus is current."
The teacher, Ms. Anders, was visibly upset. "She must have found the bottle on the playground. I got her here right away. It looks deep," she fretted.
"We'll take good care of her, Ma'am," Gallant soothed.
"That's right," Pratt said, then looking at the chart for the name, he asked, "OK, Kiesha, can I see your hand please?"
Kiesha didn't answer, but when Pratt reached for her, she pulled her hand back and held it against her body protectively.
"Kiesha?" He asked again. Getting no response, he turned to her teacher, "Can she talk?"
"Yes," Ms. Anders explained, "but she doesn't very often, and not usually to people she's just met. She understands most of what you say to her, as long as she's tuned in." Addressing the girl, she told her, "Kiesh, you need to let the doctors take care of your hand. It's OK. Nobody's going to hurt you."
With prompting from her teacher, Kiesha slowly uncurled her arm and cooperated as Pratt and Gallant irrigated and disinfected the wound. The residents were about to begin suturing, when a crash and screaming came from outside. Ms. Anders groaned, recognizing the cries. "That's one of mine," she sighed, looking toward the door.
"You wanna go check on them?" Pratt offered. "We're fine here," he said, smiling toward the girl, "She's being an angel. We'll bring her out in a few minutes."
As the yelling outside intensified, the teacher nodded gratefully. Patting Kiesha on the shoulder, she got up to go, saying, "I'll be right outside."
Kiesha showed no reaction as her teacher exited the room. But she reacted strongly when Gallant approached with a needle; she pulled her hand away and tensed as if she might bolt. Pratt, sitting on her right side reached around behind her with his left arm, holding her in the chair. With his right arm across her, he secured her injured left hand, saying, "Don't worry, honey, this won't hurt a bit."
Pratt's attempts to restrain and calm the child had the opposite effect. She went ballistic, kicking and thrashing. She managed to knock the needle from Gallant's hands and arched upwards to escape Pratt's grasp. When Pratt moved his arm up to compensate, she bit down hard on his forearm. Suppressing a curse, he pulled his arm away and ducked his head - inadvertently bringing his face within reach of Kiesha's foot. The toe of her shoe connected solidly with his nose.
Pratt yelped and backed away. Surprisingly, Keisha did not get up and run, but, instead, curled into herself on the chair. Pratt felt his nose and discerned that it wasn't broken. "Oh man, I'm bleeding," he moaned, "let me get it stopped and I'll be back in a minute."
Pratt left the room, applying pressure to his oozing proboscis. Gallant gathered the supplies that had been strewn in the scuffle, and watched his patient go from thrashing wildcat to silent lump in the blink of an eye. The door opened. Gallant looked over, surprised that his fellow resident could return so quickly.
Instead of Greg, Dr. Romano entered the room, laughing softly. He addressed the little girl in a delighted tone, "You hurt Pratt!"
'It's nice to hear him laugh,' Gallant thought, shaking his head, bemused, 'Of course it would be nicer if he wasn't laughing at somebody else's misfortune.'
Kiesha was apparently unused to having her violent outbursts met with such glee. She looked up at Dr. Romano, her placid mask turning into a slightly puzzled expression.
"You know, we're going to have to stitch up your hand, sweetheart, even if you're not crazy about the idea," Romano told her matter-of-factly. Then, addressing Gallant, he asked, "How far did you get?"
"Cleaned and irrigated, but it might've been contaminated when she moved."
Romano nodded, "We'll numb, then re-disinfect and suture." Turning to Kiesha, he said, "I'm going to hold your hand steady so Dr. Gallant can give you a shot and sew up your cut. He'll put something on your hand so the needle won't hurt much. It might sting for a second, then your hand will feel tingly."
He placed his hand, palm up, on the table, and gestured with his head to indicate that she should do the same. At first, she did nothing. But after several seconds she slowly complied, placing her up-turned left hand on top of his right. He lightly curled his pinky finger around her wrist and held her fingers straight with his thumb.
Gallant noticed that, while their patient's hand was restrained fairly securely, the rest of her was not. Romano was sitting on Kiesha's right side, in the chair Pratt had vacated, with a good foot and a half between his body and hers. His prosthetic arm was hanging down at his side. If the girl managed to pull away from his grip on her hand, there was no way he would be able to grab her. 'Oh, well,' Gallant reasoned, 'grabbing her didn't work so well last time anyway.'
Kiesha was tense, but still, as Gallant administered the injection. She relaxed almost imperceptibly when it was over. Romano whispered, "Good girl." Kiesha looked over at him. He met her gaze with a twinkle in his eye, then looked down at his lap and then back at her. Much to Gallant's surprise, the child accepted this nonverbal invitation and scooted over onto Romano's lap.
As Gallant began suturing, Romano quietly asked, "Kiesha, did you do this on purpose?" glancing toward her hand. She didn't exactly nod in reply, but there was something affirmative about the way she cocked her head. Romano continued, "Well, don't do that again." His tone was serious, but with an edge of wry self-consciousness at the absurdity of trying to reason with a kid who intentionally mangles herself.
The girl stared up at Romano intently; then she reached up with her free hand and touched his face. Reflexively, he drew back a little, but the way they were positioned there really wasn't anywhere for him to go. Lightly, she tapped her fingertips along his beard, from one end to the other. She tilted her head back and giggled, a low musical sound, while patting the side of his face.
Gallant, watching out of the corner of his eye, had to force himself not to laugh. Romano had a rare unguarded, almost silly, smile on his face. He looked confused, but was clearly charmed by the girl's bizarre display of affection. Then, as suddenly as Kiesha started, she stopped. Sticking her thumb in her mouth, she curled up against Romano's chest and rested quietly through the remainder of the procedure.
*****
After returning Kiesha to her teacher and discussing follow-up care, Robert entered the lounge. Pratt was sitting on the couch with an ice pack pressed against his nose. The bleeding had stopped, but there was still a little swelling. A nicer man would have offered sympathy, or at least not gloated. Robert was not such a man. He laughed at Pratt, saying, "Wait 'till you see what I told Miguel to do to you."
Pratt was galled by Romano's attitude, but also amused at the older man's complete lack of subtlety - 'the little prick can't even pretend he's not enjoying this'. He growled back, "Keep your minions away from me."
Romano chuckled. He couldn't remember the last time he was in such a good mood. It was fun to watch the arrogant lout suffer. And succeeding where another guy failed, even if it was at something as insignificant as wrangling a nutty little kid, was icing on the cake.
Since Anspaugh's reprieve, Pratt continued to be a thorn in Romano's side. It wasn't Pratt's arrogance, exactly, that pissed him off. It wasn't even the fact that the resident didn't have the goods to back up his high opinion of himself. Frankly, few people did - the world of medicine was full of enormous egos held up by flimsy platforms of talent. No, what really bugged Romano about Pratt was that Pratt thought HE was incompetent. Each time he gave Pratt an order there was that skeptical look, questioning whether Romano knew what he was talking about.
It drove Robert nuts. "Rocket Romano" had never been incompetent at anything in his life. He knew that others regarded him as a mean son-of-a- bitch, but there was always the understanding that he was truly excellent at his craft. Until recently, that is. Now, while he was better than Pratt gave him credit for, he would never again be the best of the best. And he wasn't really sure how to live with being mediocre. 'Aw, hell - I just talked myself out of my good mood,' he thought, groaning softly.
As if on cue, another mood-killer walked through the door of the lounge. Morris shuffled in, glanced around, saw the unwelcoming eyes of his colleagues, grabbed a piece of cold pizza from the 'fridge, and split. Romano shook his head, still disgusted with the red-haired resident's inept performance earlier. He tried to focus on happier thoughts, like Pratt bleeding. Only Pratt wasn't bleeding any more, and now he was speaking:
". . . you don't see anything odd about the fact that I'M the one you're trying to fire?"
"Why are you talking to me? You know I hate that," Romano responded dismissively.
"You can't possibly think that I'm the worst resident here. But I'm the one you're gunning for. In my book, that's discrimination."
"Oh, fine. After I get rid of you, Red's next. Happy?"
"I'm serious, man," Pratt pressed, growing irritated with Romano's flip attitude.
"What do you want me to say?" Romano sighed, "You're reckless and annoying, and I want you gone. Fortunately for you, the powers-that-be don't give a rat's ass what I want. Anyway, it's considerably harder to fire somebody like Morris."
"Why?" Pratt asked, taking advantage of his supervisor's atypical candor.
"Because he's an idiot. It's not like he's doing it on purpose." At Pratt's frown, he continued, "Hey, if it were up to me we'd do IQ tests like the airlines do drug tests . . ."
Hearing the word 'drug', Pratt scrutinized Romano's expression as the older man continued talking: ". . . med school and first year residency are supposed to weed out this kind of thing . . ."
'Nope. He's clueless,' Pratt concluded. This presented Greg with an ethical dilemma. He had nothing but contempt for Morris, but he had been trying to make a point to Romano, not get the other resident in trouble. Unfortunately, if he was right, Morris might pose a significant risk to patient care. He deliberated with himself, 'It's not my job to rat out other residents, especially not to a creep like Romano. But I can't just do nothing. He's the boss; he needs to know what's going on. And if he's not with-it enough right now to figure it out, somebody's gotta tell him. Damn.'
"Earth to Pratt," Romano interrupted the other man's thoughts, "You're the one who wanted to have this conversation, not me."
Instead of responding to Romano's jibe, Pratt addressed him in a pained voice, "If I tell you something, do you promise not to overreact?"
"No. Tell me anyway."
Pratt hesitated, weighing his options.
Romano prompted impatiently, "What?" Noticing Pratt's troubled expression, he repeated less harshly, "What?"
"I think Morris is using pot," Pratt blurted, before he could change his mind.
Romano snorted, "So what?"
'OK,' Pratt thought, 'I hadn't counted on him UNDERreacting . . .' Then he amended, "I don't mean on weekends, on shift."
Romano sobered and asked quietly, "What's your evidence?"
"Not a lot. And I don't want to come down on him in case I'm wrong. But he comes in smelling like it - says it's his roommate smoking. Sometimes the smell is stronger after he goes outside for a break. And one of his patients claimed that his doc lifted his 'herbal remedy' for glaucoma."
Romano looked lost in thought for a moment, then he said, "They won't let me do random drug tests, so it's one resident's word against another's. That's not enough to support a formal accusation. Especially since it could be interpreted as you trying to take the heat off yourself . . ."
Pratt opened his mouth to protest, but Romano waved it away, saying, "I know." Then he continued, "I'll keep closer tabs on him. If he thinks I'm coming down on him, that may be enough to get him to quit using around work hours. Of course, that'll leave us with his normal not-chemically-enhanced level of uselessness."
Pratt nodded, still uncomfortable with what he'd done.
Romano caught his eye and asked softly, "That really sucked for you, huh? Having to tell me?"
Pratt mumbled, "Yup." He thought he saw something like admiration in Romano's expression, momentarily.
Then it was gone, and Romano smirked, "Almost as bad as getting beat up by an eight-year-old girl . . ."
Pratt let out an exasperated sigh, as Romano left the lounge snickering softly at his expense.